Diabetic Neuropathy (DN) is a nervous disorder caused by diabetes mellitus, among other illnesses. It is associated with multiple factors related to high blood sugar levels and reduced insulin availability. This condition is the result of a series of complex metabolic interactions that affect blood vessels, including immune, and neurotrophic that cause inflammation, malfunction, and permanent damage to the nervous system.
When seeking treatment for DN, the best way to manage this condition is to
achieve an adequate metabolic control. Numerous studies have shown that in both type 1 and 2 diabetes, maintaining your blood glucose levels as close to normal as possible can delay the onset and progression of complications caused by diabetes. It also leads to improvements in sensitivity perception.
Keeping a constant medical control and a good management of the risk factors which condition the appearance of diabetes complications can also reduce the development of neuropathy in patients with type 2 diabetes. For that reason, the use of oral drugs prescribed by your doctor to control hypertension, hypoglycemia, and blood lipids such as aspirin and antioxidants should not be discontinued.
Antioxidants such as Alpha-Lipoic Acid increase glucose uptake thereby improving neuron function and transmission; therefore, it is an excellent alternative to treat diabetic neuropathy.
Pain management in patients with diabetic neuropathy is extremely complex. It should be taken into account that every patient responds differently to pain. For this reason, any treatment must be tailored according to each patient’s condition. Medications normally used to treat DN include the following:
- Pregabalin: commercially available under the name of Lyrica®. This is a drug basically used to treat neuropathic pain, but it can also be employed to treat anxiety and epilepsy. Adverse side effects include drowsiness, dizziness, and nausea.
- Duloxetine: this drug works by modifying the rate at which those chemicals that transmit information among the neurons, called neurotransmitters, are released. As a result, patients suffering from neuropathic pain experience relief. It is also used as an antidepressant. The adverse side effects include headaches, nausea, mouth dryness, fatigue, drowsiness, and insomnia.
- Amitriptyline: it has the same mode of action as Duloxetine. It belongs to the group of tricyclic antidepressants used for treating neuropathic pain as well as headaches due to hypertension, migraines, and anxiety. It is not recommended in cases of glaucoma, prostatic hyperplasia (prostate gland enlargement), or cardiac arrhythmia.
- Gabapentine: acts as a neurotransmitter called Gamma Aminobutyric Acid (GABA) for the relieve of neuropathic pain. It was originally developed to treat Epilepsy. Most common side effects include vertigo, drowsiness, mood swings, and swelling of legs and arms.
If pain persists, an opiate drug such as Tramadol can be administered in combination with other drugs including antidepressants or anticonvulsants.
In the case of Autonomic Neuropathy, digestive symptoms may improve by modifying patient’s diet or with the use of prescription drugs, such as Metoclopramide, which favor intestinal transit. All this information indicates that there are a variety of options in the treatment of this disorder. On the other hand, while other drugs such as Sildenafil, Vardenafil or Tadalafil indicated in DiabeTV are available for treating erectile dysfunction, the patient can talk to his doctor and discuss the use of the drugs referred in this article. Nevertheless, keep in mind that the key player when it comes to preventing Diabetic Neuropathy, is the patient!